DR Congo’s Ebola outbreak spreads to eight provinces as many die at home

The Ebola outbreak in the Democratic Republic of Congo, caused by the Bundibugyo virus, has now reached 66 health zones in eight provinces, the World Health Organization said in an update on 23 October.

As of 20 October, WHO had recorded 9,704 confirmed cases and 4,687 deaths, a crude case fatality ratio of 48.3% among confirmed cases. Transmission remains sustained and high, the agency said.

Dying before reaching care

The most worrying figure may be where people are dying. Of 482 deaths reported since WHO’s previous update, 307 happened in communities and only 175 in treatment centres. That suggests many patients are not being found early or cannot reach care in time.

An earlier WHO report, using data up to 19 October, recorded the virus reaching Wapinda Health Zone in Nord-Ubangi province. It warned that growing insecurity, people fleeing their homes and blocked humanitarian access were undermining efforts to track and contain the disease. Ituri has the most cases, with heavy transmission in Nord-Kivu and Haut-Uélé too.

Beyond Congo’s borders

Cases linked to travel have now turned up in Kenya and Nigeria. WHO has urged countries in the region to step up border surveillance and screening and to find cases quickly. But the heaviest burden by far is still in Congo.

Related reporting: Nigeria confirms first imported Ebola case in Abuja; Kenya’s Ebola cases rise to nine, all linked to one patient.